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25 Cards in this Set

  • Front
  • Back
During an outbreak of meningitis at a local
college, a 20-year-old young student presents
to a hospital emergency room complaining
of headache, fever, chills, and stiff neck.
On examination, it appears that he may have
meningitis and needs a lumbar puncture or a
spinal tap. Cerebrospinal fluid (CSF) is normally
withdrawn from which of the following
spaces?
(A) Epidural space
(B) Subdural space
(C) Space between the spinal cord and pia
mater
(D) Subarachnoid space
(E) Space between the arachnoid and dura
maters
D
A 23-year-old jockey falls from her horse
and complains of headache, backache, and
weakness. Radiologic examination would reveal
blood in which of the following spaces if the internal
vertebral venous plexus was ruptured?
(A) Space deep to the pia mater
(B) Space between the arachnoid and dura
maters
(C) Subdural space
(D) Epidural space
(E) Subarachnoid space
D
3. A 42-year-old woman with metastatic
breast cancer is known to have tumors in the
intervertebral foramina between the fourth
and fifth cervical vertebrae and between the
fourth and fifth thoracic vertebrae. Which of
the following spinal nerves may be damaged?
(A) Fourth cervical and fourth thoracic nerves
(B) Fifth cervical and fifth thoracic nerves
(C) Fourth cervical and fifth thoracic nerves
(D) Fifth cervical and fourth thoracic nerves
(E) Third cervical and fourth thoracic nerves
D
4. A 39-year-old woman with headaches presents
to her primary care physician with a possible
herniated disk. Her magnetic resonance
imaging (MRI) scan reveals that the posterolateral
protrusion of the intervertebral disk between
L4 and L5 vertebrae would most likely
affect nerve roots of which of the following
spinal nerves?
(A) Third lumbar nerve
(B) Fourth lumbar nerve
(C) Fifth lumbar nerve
(D) First sacral nerve
(E) Second sacral nerve
C
57-year-old woman comes into her
physician's office complaining of fever, nausea,
vomiting, and the worst headache of her life.
Tests and physical examination suggest hydrocephalus
(widening ventricles) resulting from a
decrease in the absorption of cerebrospinal
fluid (CSF). A decrease of flow in the CSF
through which of the following structures
would be responsible for these findings?
(A) Choroid plexus
(B) Vertebral venous plexus
(C) Arachnoid villi
(D) Internal jugular vein
(E) Subarachnoid trabeculae
C
After his car was broad-sided by a large
truck, a 26-year-old man is brought to the
emergency department with multiple fractures
of the transverse processes of the cervical and
upper thoracic vertebrae. Which of the following
muscles might be affected?
(A) Trapezius
(B) Levator scapulae
(C) Rhomboid major
(D) Serratus posterior superior
(E) Rectus capitis posterior major
B
27-year-old mountain climber falls from a
steep rock wall and is brought to the emergency
department. His physical examination and computed
tomography (CT) scan reveal dislocation
fracture of the upper thoracic vertebrae. The
fractured body of the T4 vertebra articulates with
which of the following parts of the ribs?
(A) Head of the third rib
(B) Neck of the fourth rib
(C) Tubercle of the fourth rib
(D) Head of the fifth rib
(E) Tubercle of the fifth rib
D
young toddler presents to her pediatrician
with rather new onset of bowel and bladder
dysfunction and loss of the lower limb
function. Her mother had not taken enough
folic acid (to the point of a deficiency) during
her pregnancy. On examination, the child has
protrusion of the spinal cord and the meninges
and is diagnosed with which of the following
conditions?
(A) Spina bifida occulta
(B) Meningocele
(C) Meningomyelocele
(D) Myeloschisis
(E) Syringomyelocele
C
A 34-year-old woman crashes into a tree
during a skiing lesson and is brought to a hospital
with multiple injuries that impinge the
dorsal primary rami of several spinal nerves.
Such lesions could affect which of the following
muscles?
(A) Rhomboid major
(B) Levator scapulae
(C) Serratus posterior superior
(D) Iliocostalis
(E) Latissimus dorsi
D
During a domestic dispute, a 16-year-old
boy receives a deep stab wound around the superior
angle of the scapula near the medial border,
which injures both the dorsal scapular and
spinal accessory nerves. Such an injury could
result in paralysis or weakness of which of the
following muscles?
(A) Trapezius and serratus posterior superior
(B) Rhomboid major and trapezius
(C) Rhomboid minor and latissimus dorsi
(D) Splenius cervicis and sternocleidomastoid
(E) Levator scapulae and erector spinae
B
An elderly man at a nursing home is
known to have degenerative brain disease.
When cerebrospinal fluid (CSF) is withdrawn
by lumbar puncture for further examination,
which of the following structures is most likely
penetrated by the needle?
(A) Pia mater
(B) Filum terminale externum
(C) Posterior longitudinal ligament
(D) Ligamentum flavum
(E) Anulus fibrosus
D
A 27 year-old-stuntman is thrown out of
his vehicle prematurely when the car used for
a particular scene speeds out of control. His
spinal cord is crushed at the level of the fourth
lumbar spinal segment. Which of the following
structures would most likely be spared from
destruction?
(A) Dorsal horn
(B) Ventral horn
(C) Lateral horn
(D) Gray matter
(E) Pia mater
C
A 24-year-old woman comes to a hospital
to deliver her baby. Her obstetrician uses a caudal
anesthesia during labor and childbirth to
block the spinal nerves in the epidural space.
Local anesthetic agents are most likely injected
via which of the following openings?
(A) Intervertebral foramen
(B) Sacral hiatus
(C) Vertebral canal
(D) Dorsal sacral foramen
(E) Ventral sacral foramen
B
In a freak hunting accident, a 17 year-old
boy was shot with an arrow that penetrated
into his suboccipital triangle, injuring the suboccipital
nerve between the vertebral artery
and the posterior arch of the atlas. Which of
the following muscles would be unaffected by
such a lesion?
(A) Rectus capitis posterior major
(B) Semispinalis capitis
(C) Splenius capitis
(D) Obliquus capitis superior
(E) Obliquus capitis inferior
C
26-year-old heavyweight boxer is punched
on his mandible, resulting in a slight subluxation
(dislocation) of the atlantoaxial joint.
The consequence of the injury was decreased
range of motion at that joint. What movement
would be most affected?
(A) Extension
(B) Flexion
(C) Abduction
(D) Adduction
(E) Rotation
E
16. A crush injury of the vertebral column can
cause the spinal cord to swell. What structure
would be trapped between the dura and vertebral
body by the swelling spinal cord?
340 BRS GROSS ANATOMY
(A) Anterior longitudinal ligament
(B) Alar ligament
(C) Posterior longitudinal ligament
(D) Cruciform ligament
(E) Ligamentum nuchae
E
A 44-year-old woman comes to her physician
and complains of headache and backache.
On examination, she is found to have fluid accumulated
in the spinal epidural space because
of damage to blood vessels or meninges.
Which of the following structures is most likely
ruptured?
(A) Vertebral artery
(B) Vertebral vein
(C) External vertebral venous plexus
(D) Internal vertebral venous plexus
(E) Lumbar cistern
D
A 69-year-old man has an abnormally increased
curvature of the thoracic vertebral column.
Which of the following conditions is the
most likely diagnosis?
(A) Lordosis
(B) Spina bifida occulta
(C) Meningocele
(D) Meningomyelocele
(E) Kyphosis
E
During a snowstorm, a 52-year-old man is
brought to the emergency department after a
multiple car pile-up. Which of the following
conditions is produced by a force that drives
the trunk forward while the head lags behind
in a rear-end automobile collision?
(A) Scoliosis
(B) Hangman's syndrome
(C) Meningomyelocele
(D) Whiplash injury
(E) Herniated disk
D
A 37-year-old man is brought to the emergency
department with a crushed second cervical
vertebra (axis) he suffered after a stack of pallets
fell on him at work. Which of the following
structures would be intact after the accident?
(A) Alar ligament
(B) Apical ligament
(C) Semispinalis cervicis muscle
(D) Rectus capitis posterior minor
(E) Obliquus capitis inferior
D
A middle-aged coal miner injures his back
after an accidental explosion. His magnetic resonance
imaging (MRI) scan reveals that his
spinal cord has shifted to the right because the
lateral extensions of the pia mater were torn.
Function of which of the following structures
is most likely impaired?
(A) Filum terminale internum
(B) Coccygeal ligament
(C) Denticulate ligament
(D) Choroid plexus
(E) Tectorial membrane
C
A 25-year-old man with congenital abnormalities
at birth has a lesion of the dorsal
scapular nerve, making him unable to adduct
his scapula. Which of the following muscles is
most likely paralyzed?
(A) Semispinalis capitis
(B) Rhomboid major
(C) Multifidus
(D) Rotator longus
(E) Iliocostalis
B
After an automobile accident, a back muscle
that forms the boundaries of the triangle of
auscultation and the lumbar triangle, receives
no blood. Which of the following muscles
might be ischemic?
(A) Levator scapulae
(B) Rhomboid minor
(C) Latissimus dorsi
(D) Trapezius
(E) Splenius capitis
C
A 38-year-old woman with a long history
of shoulder pain is admitted to a hospital for
surgery. Which of the following muscles becomes
ischemic soon after ligation of the superficial
or ascending branch of the transverse
cervical artery?
(A) Latissimus dorsi
(B) Multifidus
(C) Trapezius
(D) Rhomboid major
(E) Longissimus capitis
C
A 25-year-old soldier suffers a gunshot
wound on the lower part of his back and is unable
to move his legs. A neurologic examination
and magnetic resonance imaging (MRI)
scan reveal injury of the cauda equina. Which
of the following is most likely damaged?
(A) Dorsal primary rami
(B) Ventral primary rami
(C) Dorsal roots of the thoracic spinal nerves
(D) Ventral roots of the sacral spinal nerves
(E) Lumbar spinal nerves
D